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Everybody’s Business
Integrated mental health services for older adults
A service development guide
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Everybody’s Business: Guidance and Key Messages
Lesley Carter and Claire Goodchild
London
Care Services Improvement Partnership
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The sections:
• Introduction
• Foundations
• Primary and community care
• Intermediate care
• Care for people in the general hospital
• Other specialist mental health services
• Special groups
• Annexes: Service assessment, policy drivers
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Everybody’s Business
Integrated mental health services for older adults
Key messages for Commissioners
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1) Older people’s mental health is everyone’s business
• Mental health problems are widespread: 40% of people visiting their GP 50% of general hospital inpatients 60% of people who live in care homes
• Depression is more common and worsens outcome in people with long term conditions
• Population increase in the next 10 years:15% increase in the over 65s27% increase in the over 85s
• Caring for people with Alzheimer’s disease costs more than the combined cost of stroke, cancer and heart disease
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2) Improving services for older people with mental health problems will help meet national targets and standards
• Commissioners can: Improve outcomes for service users and carers
Generate savings by improved efficiency
• Improving mental wellbeing in older people will support the delivery of a number of national targets and core standards:
Reducing emergency inpatient bed days Enabling people to live independently at home Reducing death from suicide
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3) Access to mental health services should be based on need not age
• DH is committed to age equality in mental health services
• Services need to be user led rather than service led
• The specialist service requirements of older people with mental health problems still need to be recognised and addressed
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4) Older people need holistic care in mainstream services
• DH is committed to developing health and care services that address mental and physical health needs
• Services should start with the needs of the individual, offer choice and support wellbeing and independence
• Whatever the setting, older people with mental health problems should not be discriminated against and should have their mental health needs met.
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5) Workforce development is central to driving service improvement
• Older people with mental health problems and their carers often have complex needs. There are few areas where the quality of the workforce matters more• A properly skilled workforce throughout health and social care is fundamental to delivering better mental health for older people
• It is vital to include mainstream staff in workforce development, education and training as well as staff specialising in mental health care
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6) Whole system commissioning and leadership are vital to deliver a comprehensive service
• A co-ordinated approach is needed across all health and social care – with links to housing, the voluntary sector etc
• Strong leadership across health, social services, local authorities and the voluntary sector is essential to:
Communicate the vision of age inclusive and holistic servicesEnsure the delivery of lasting results
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So what is going to make it happen?
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Supports:
• DH OPMH Programme Board
• Care Services Improvement Partnership: website: www.everybodysbusiness.org.uk
• Service and financial mapping
• The Commission for Social Care Inspection and the Healthcare Commission
• Our health, our care, our say: a new direction for community services: “Commissioners and providers of services will need to become familiar with this guide”
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Quality and Outcomes Framework(Changes from April 2006)
• Making working age adult mental health indicators age-inclusive
• Screening for depression in people with diabetes and heart disease
• New indicators involving a dementia register in primary care
• Extending the palliative care disease register to people with frailty and dementia
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What happens next?
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Other key events to watch out for: -
• ‘Next Steps’ – NSF update
• SCIE/NICE Dementia Guideline
• Mental Capacity Act implementation
• Mental Health Bill
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London CSIP implementation programmeOPMH programme• OPMH network
―Frontline providers ―Commissioners/strategic planning
• Service improvement directly with mental health trusts
• Influencing wider CSIP mental health programmes• Working alongside King’s Fund OPMH
Development Programme• Working with the whole system• Supporting OPMH needs across health and social
care
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Supporting Implementation
Web based resources • OPMH websitewww.olderpeoplesmentalhealth.csip.org.uk• Change Agent Team websitewww.changeagentteam.org.uk
[email protected]@dh.gsi.gov.uk